Chicago moves closer to easing pharmacist workload

Chicago has moved a step closer to placing major restrictions on pharmacist workloads in a bid to improve consumer safety.

The City Council Finance Committee on Tuesday approved a measure that would allow Chicago pharmacists to fill prescription orders for no more than 10 patients per hour, as well as guaranteeing meal and washroom breaks. It also would require pharmacies to post a list in plain sight showing which pharmacists and technicians have worked shifts longer than eight hours.

The proposal’s sponsor, Ald. Edward Burke, the committee’s chairman, said he hoped to bring the plan up for a vote in the full City Council soon but did not expect that to happen Wednesday.

The 14th Ward alderman has argued that the proposal would reduce the “undue levels of stress” on pharmacists caused by pressure from retailers to fill hundreds of prescriptions a day. Pharmacists working constantly for as long as 12 hours a day have said they worry about losing focus during busy shifts and potentially putting their customers in jeopardy.

The bottom line, Burke said, is that the public is placed at risk.

Burke’s proposal came in response to a 2016 Tribune investigation that found pharmacies frequently failed to warn customers about dangerous interactions between prescription drugs. The newspaper found that 52 percent of 255 chain and independent pharmacies tested in the Chicago area and nearby states failed to warn reporters when they bought pairs of drugs that could be harmful or even fatal if taken together.

The investigation prompted safety improvements by CVS, Walgreens, Walmart, Costco, Kmart and local grocer Mariano’s, chains representing more than 23,000 U.S. drugstores. The changes have the potential to affect millions of consumers.

In addition, Illinois Gov. Bruce Rauner pushed successfully to require pharmacists to provide counseling to patients who pick up a new prescription or see a change in a longtime prescription, such as frequency or size of a dose of medicine. The previous requirement was that counseling must be offered; often, a pharmacy staffer merely asked: “Do you have any questions for the pharmacist?”

The City Council action could lead to a second significant change in government oversight of pharmacies prompted by the Tribune investigation.

Along with the 10-patient-per-hour limit, Burke’s Chicago proposal would give pharmacists who work at least seven hours in a shift two 15-minute breaks and one 30-minute meal break. A pharmacy also would need to schedule at least 10 pharmacy technician hours per 100 prescriptions filled.

The plan also would prohibit pharmacies from using staff metrics or productivity quotas that include activities unrelated to filling drug orders, such as promotions pushing flu shots. Some pharmacists have complained about the growing number of duties in high-volume pharmacies.

Violators could be fined $250 to $1,500 a day.

Extensive whistleblower protections are also included in the proposal, a move aimed at encouraging pharmacists to speak up if they see a safety issue that needs to be addressed.

Testifying against the proposal last week, Garth Reynolds of the Illinois Pharmacists Association said millions of prescriptions would go unfilled in Chicago each year if the limits were put in place.

Reynolds, the group’s executive director, warned that the restrictions would be tantamount to “rationing care.”

Reynolds and the Illinois Retail Merchants Association also argued that the city does not have jurisdiction, saying this type of regulation is up to the state of Illinois.

Burke maintained that the city has authority, likening the proposal to the way Chicago set its own minimum wage law.

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